EVERGREEN MANOR NPI 1760712400

NPI Information

NPI: 1760712400
Provider Name: EVERGREEN MANOR
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
2601 SUMMIT AVE
EVERETT, WA
ZIP 98201
Phone: (425) 258-2407
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EVERGREEN MANOR is an addiction (substance use disorder) counselor in Everett, WA. EVERGREEN MANOR NPI is 1760712400. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2601 SUMMIT AVE
EVERETT, WA
ZIP 98201-309
Phone: (425) 258-2407

The provider's authorized official is Marcia Broude .
The authorized official title is Office Manager and has the following contact phone number (425) 258-2407.

The enumeration date for this NPI number is 12/31/2009 and was last updated on 12/31/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	LH00010886	WASHINGTON	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CP00006404	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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